European Journal of Gastroenterology & Hepatology最新文献

{"title":"Efficiency of opportunistic population screening in a gastrointestinal endoscopy unit as a hepatitis C elimination strategy.","authors":"Antonio García-Herola, María S Sánchez-Reyes, Laura Gómez-Escolar, Laura Llobregat, Elisenda Martín-Fernández, Verónica Pascual, Isabel López-Martín","doi":"10.1097/MEG.0000000000002973","DOIUrl":"10.1097/MEG.0000000000002973","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility and acceptance of an opportunistic population-based screening program in a gastrointestinal endoscopy unit as a hepatitis C elimination strategy.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in the Digestive Endoscopy Unit of a hospital in Spain between February 2019 and 2020.</p><p><strong>Results: </strong>The participation rate was 99.6%, and 4701 individuals were evaluated. The median age was 60 years, and 53.4% were women. A total of 70 participants were positive for hepatitis C virus (HCV) antibodies. The seroprevalence was 1.49% [95% confidence interval (CI): 1.14-1.84%]. Less than one-third of the HCV antibody-positive subjects were unaware of their condition. The overall active HCV infection prevalence was 0.26% (95% CI: 0.11-0.41%). The most frequent risk factors were previous surgical interventions and drug consumption. Approximately 80% of the anti-HCV-positive individuals were born between 1950 and 1980.</p><p><strong>Conclusions: </strong>Opportunistic screening of HCV-infected patients older than 40 years could contribute to the identification of HCV-infected patients and linkage to care for hepatitis C elimination at the hospital level. Gastrointestinal endoscopy units can be a good setting for opportunistic screening.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1003-1009"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of postcolonoscopy colorectal cancer following single-session endoscopic polypectomy: a retrospective cohort study using nationwide claims data.","authors":"Munenori Honda, Atsushi Takayama, Satomi Yoshida, Koji Kawakami","doi":"10.1097/MEG.0000000000003013","DOIUrl":"10.1097/MEG.0000000000003013","url":null,"abstract":"<p><strong>Objective: </strong>Colonoscopy is essential for colorectal cancer prevention. In Japan, two primary strategies for polypectomy are employed: single-session polypectomy, which combines diagnostic and therapeutic procedures in a single session, and deferred polypectomy, which is performed after a diagnostic colonoscopy. However, the impact of different polypectomy strategies remains unclear. This study aimed to investigate this evidence gap by comparing the postcolonoscopy colorectal cancer (PCCRC) incidence between the two strategies.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the Japan Medical Data Center claims database. Patients aged 40-70 years who underwent initial therapeutic colonoscopy between April 2012 and December 2018 were included. The primary outcome was the incidence of PCCRC during the 4-year follow-up period. For primary analysis, the weighted hazard ratio (HR) was calculated using the Cox hazard model with inverse probability of treatment weighting (IPTW) and inverse probability of censoring weighting (IPCW).</p><p><strong>Results: </strong>Among the 86 016 patients included, 71 027 were assigned to the single-session polypectomy group and 14 989 were assigned to the deferred polypectomy group. The incidence rates of PCCRC were 0.46 and 0.34 per 1000 person-years in the single-session and deferred polypectomy groups, respectively. The weighted HR with IPTW and IPCW in the single-session polypectomy group was 2.61 (95% confidence intervals: 1.25-5.44) compared to the deferred polypectomy group.</p><p><strong>Conclusion: </strong>This study provides the first large-scale evidence that single-session polypectomy is associated with a higher risk of PCCRC compared to deferred polypectomy. Our findings highlight the need to improve diagnostic accuracy during therapeutic colonoscopy and further optimize single-session polypectomy techniques.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1026-1033"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of acute severe ulcerative colitis at initial presentation.","authors":"Diogo Couto Sousa, Samuel Raimundo Fernandes, Sofia Saraiva, Ana Rita Gonçalves, Ana Valente, Paula Moura Santos, Luís Correia","doi":"10.1097/MEG.0000000000003015","DOIUrl":"10.1097/MEG.0000000000003015","url":null,"abstract":"<p><strong>Background: </strong>20-25% of patients with ulcerative colitis (UC) will experience at least one episode of acute severe ulcerative colitis (ASUC). Up to 20% of nonresponders to medical treatment require surgery during the index episode. For approximately one-third of the patients, ASUC is the first manifestation of the disease, presenting unique challenges.</p><p><strong>Methods and aims: </strong>Retrospective cohort study including 185 patients hospitalized with ASUC. We aim to compare the clinical outcomes between patients with new-onset and established UC.</p><p><strong>Results: </strong>62 (33.5%) patients had new-onset, while 123 (66.5%) had established UC. Demographic and baseline clinical characteristics were similar between groups. Patients with new-onset UC experienced longer hospitalizations (19 ± 22 vs. 12 ± 11 days; P  = 0.002), longer delay until receiving rescue therapy [11 vs. 6 days (interquartile range : 6-8 days); P  = 0.014] and more severe bacterial infections (16 vs. 4%; P  = 0.005). We found no significant differences in steroid response ( P  = 0.719), need for rescue therapy ( P  = 0.522), response to rescue therapy ( P  = 0.234), colectomy ( P  = 0.655), mortality ( P  = 0.516), and hospital readmission ( P  = 0.929) between groups. After 1 year, colectomy or death occurred in 13.5% of patients. Independent predictors of adverse outcomes included active smoking, extensive colitis, the need for rescue therapy, and severe bacterial infections - but not new-onset disease.</p><p><strong>Conclusion: </strong>Major clinical outcomes were similar between patients with new-onset and established UC.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1034-1039"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-life data on hepatocellular carcinoma in the French prospective CHIEF cohort in the era of immunotherapy.","authors":"Eric Nguyen-Khac, Philippe Merle, Hajer Ben Khadhra, Amaddeo Giuliana, Thomas Decaens, Thomas Uguen, Jean-Frédéric Blanc, Nathalie Ganne-Carrie, Mohamed Bouattour, Stéphane Cattan, Christine Silvain, Ghassan Riachi, Jean-Marie Peron, Rodolphe Anty, Jean-Pierre Bronowicki, Aurore Baron, Georges-Philippe Pageaux, Véronique Loustaud-Ratti, Frédéric Oberti, Manon Allaire, Sylvain Manfredi, Yasmina Ben Merabet, Isabelle Ollivier-Hourmand, Marie Lequoy, Jean-Baptiste Nousbaum, Moana Gelu-Simeon, Lucien Grados, Pierre Nahon, Charlotte Costentin, Jean Claude Barbare, Gérard Ducournau, Olivier Ganry","doi":"10.1097/MEG.0000000000002982","DOIUrl":"10.1097/MEG.0000000000002982","url":null,"abstract":"<p><strong>Background: </strong>The burden of hepatocellular carcinoma (HCC) increases worldwide. We report the current landscape of HCC, in France.</p><p><strong>Methods: </strong>Carcinome HépatocellulaIrE en France (CHIEF) is a national, prospective, observational cohort initiated in 2019 with the aim of including 5000 patients with HCC, with a 5-year follow-up for each. CHIEF Epidemio 2000, is the first global analysis.</p><p><strong>Results: </strong>In September 2021, 2043 patients were included in 32 centers. We analyzed 1640 patients, 86% men, 68-year-old, BMI 26.8. 70.8% of patients had cirrhosis (MELD score 9, Child-Pugh A in 77.8%, and portal hypertension in 39%. Liver disease was related to alcohol 58.5%, metabolic syndrome 39%, and virus 23.3%. HCC was confirmed by histology in 46.3%. The Milan criteria fulfilled 32.9%, median AFP 39 ng/ml, 5.9% portal thrombosis, and 10.7% metastases. BCLC classes 0, A, B, C, and D were 6.1, 29.8, 28.8, 32.1, and 3.2%, respectively. HCC was detected during a surveillance program in 35.2% associated with better survival (P < 0.001). Median follow-up was 17.76 months (29.1% deaths). The 6, 12, and 18 months overall survival rates were 84.9% (95% CI: 82.8-87), 76.7% (95% CI: 74.2-79.2), 69.3% (95% CI: 66.4-72.3). One-year survival for BCLC 0, A, B, C, and D was at 95.6, 89.7, 81.7, 54.9, and 40%, respectively (P < 0.0001). First-line treatment was curative, locoregional, or systemic in 40.5, 36.2, and 19.2%, with 1-year survival at 92.9, 82.2, and 57.8%, respectively (P < 0.0001). Atezolizumab-bevacizumab yielded a median overall survival of 17.05 months versus nine for TKI (P < 0.0001).</p><p><strong>Conclusion: </strong>In real-life data, metabolic syndrome becomes the second cause of HCC in France. The 1-year survival rates are high for all treatments applied, and Immunotherapy yields similar results than in trials.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"37 9","pages":"1063-1077"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of antithrombotic medications on postprocedural outcomes of percutaneous endoscopic gastrostomy: a US Collaborative Network study.","authors":"Khaled Elfert, Mohammed Abusuliman, Hossam Elbenawi, Hazem Abosheaishaa, Azizullah Beran, Mouhand Mohamed, Mahmoud Nassar, Matthew Krafft, Sherif E Elhanafi","doi":"10.1097/MEG.0000000000002990","DOIUrl":"10.1097/MEG.0000000000002990","url":null,"abstract":"<p><strong>Background and aims: </strong>Percutaneous endoscopic gastrostomy (PEG) is an essential procedure for patients who require long-term enteral nutrition but are unable to eat orally. However, it carries a risk of bleeding, particularly in patients on anticoagulation or dual antiplatelet therapy (DAPT). This study aimed to assess the bleeding risk associated with continuing anticoagulation or DAPT during PEG placement.</p><p><strong>Methods: </strong>Using the TriNetX US Collaborative Network Database, we analyzed four cohorts: patients on anticoagulants, patients not on anticoagulants, patients on DAPT, and patients on aspirin (ASP), focusing on gastrostomy-related bleeding within 7 and 30 days, along with secondary outcomes such as mortality and the need for blood transfusion or endoscopic reintervention.</p><p><strong>Results: </strong>Our analysis showed no statistically significant difference in the 7-day bleeding risk between the anticoagulant and no anticoagulant groups. However, a higher 30-day bleeding risk was observed in the anticoagulant group (0.9 vs. 0.4%, P  = 0.007). There was no significant difference in the incidence of severe bleeding events requiring endoscopic intervention or blood transfusion. In addition, the difference in the bleeding risk between the DAPT and ASP groups was not statistically significant within 7 and 30 days.</p><p><strong>Conclusion: </strong>These findings suggest that while anticoagulant use increases the risk of minor post-PEG bleeding, it does not lead to a higher incidence of severe bleeding. Additionally, the continuation of DAPT was not associated with statistically significant increase in bleeding risk. This study provides valuable insights into the management of antithrombotic therapy in patients undergoing PEG.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1021-1025"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant bile duct obstruction and the microbiota: encouraging advances and unanswered questions.","authors":"Gokhan Koker","doi":"10.1097/MEG.0000000000003044","DOIUrl":"10.1097/MEG.0000000000003044","url":null,"abstract":"","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"37 9","pages":"1091"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential of spironolactone to mitigate the risk of nonalcoholic fatty liver disease in hypertensive populations: evidence from a cohort study.","authors":"Di Shen, Shuaiwei Song, Junli Hu, Xintian Cai, Qing Zhu, Yingying Zhang, Rui Ma, Pan Zhou, Zhiqiang Zhang, Jing Hong, Nanfang Li","doi":"10.1097/MEG.0000000000002986","DOIUrl":"10.1097/MEG.0000000000002986","url":null,"abstract":"<p><strong>Objective: </strong>While the link between nonalcoholic fatty liver disease (NAFLD) and hypertension is well recognized, the potential protective effects of the widely used antihypertensive medication, spironolactone, on NAFLD risk remain unclear. This study aimed to evaluate the impact of spironolactone on the development of NAFLD in hypertensive patients, shedding light on its potential broader clinical benefits beyond blood pressure control.</p><p><strong>Methods: </strong>A total of 7241 participants were included. Propensity score matching (1 : 4 ratio) was employed to minimize confounding factors, creating balanced groups of spironolactone users and nonusers. Multivariate Cox regression analysis and Kaplan-Meier survival analysis were used to evaluate the association between spironolactone use and NAFLD risk. Restricted cubic splines (RCS) were applied to assess the dose-response relationship, and subgroup and sensitivity analyses were performed to validate the robustness of the findings.</p><p><strong>Results: </strong>After matching, the study included 4110 participants (822 spironolactone users and 3288 nonusers). Spironolactone use was associated with a significantly lower risk of NAFLD, with a 16.3% reduction in risk compared with nonusers (hazard ratio: 0.821; 95% confidence interval: 0.714-0.944). The RCS analysis revealed that a cumulative spironolactone dose exceeding 635 mg*months was associated with a significant reduction in NAFLD risk. Subgroup and sensitivity analyses confirmed the consistency of these findings across various patient characteristics and conditions.</p><p><strong>Conclusion: </strong>This study demonstrates a significant association between spironolactone use and a reduced risk of NAFLD in hypertensive patients, suggesting that it may have potential dual benefits in managing hypertension and protecting liver health.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1010-1020"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary intrahepatic lithiasis in western countries: role of ultrasound and comparison with MRI with MRCP.","authors":"Marie-Pierre Vullierme, Christophe Desterke, Sophie Hillaire, Béatrice Parfait, Valérie Vilgrain, Vinciane Rebours, Maïté Lewin","doi":"10.1097/MEG.0000000000002984","DOIUrl":"10.1097/MEG.0000000000002984","url":null,"abstract":"<p><strong>Objectives: </strong>To study hepatobiliary expert ultrasound (US) in a cohort of suspected primary intrahepatic lithiasis (IHL) and to compare these findings with MRI/MRCP data.</p><p><strong>Methods: </strong>All patients with a diagnosis of primary-IHL based upon biological and, or, clinical symptoms who underwent US between 2008 and 2023 were retrospectively enrolled in two tertiary hepatobiliary centers. Clinical characteristics, available genetic and radiological features (expert US and MRCP) were recorded. Data were compared for the presence of comet-tail images or stones on US, between US and MRCP features and between imaging and patients' genetic status. Statistical analyses were performed with R software environment version 4.2.1, by univariate and multivariate analysis.</p><p><strong>Results: </strong>A total of 112 primary-IHL patients were included (mean age 43 years old ±14 and 55% women). US identified primary-IHL in 92/112 (82%) patients including intrahepatic biliary comet-tail in 82/112 (73%) and stones in 51/112 (46%). Among these, 66/112 (68%) had both US and MRCP. Lithiasis was identified in 60/76 US (79%) and 44/76 MRCP (58%). MRCP showed only stones in 22/76, 29%. Genetic testing was performed in 66/112 (58%) patients. Thirty-two (49%) of these patients had pathogenic ABCB4/MDR3 gene variants, 14/66 (21%) other pathogenic variants and 5/66 (5%) had unknown significant variants. No genetic abnormalities were found in 19/66 (29%). A multivariate logistic model with the comet-tail sign as an outcome showed that there was a significant negative correlation between other pathogenic genetic variants and the comet-tail phenotype ( P -value = 0.049).</p><p><strong>Conclusion: </strong>US, and not MRCP, should be the primary diagnostic tool in suspected primary-IHL patients.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1078-1087"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomic comparative study in patients with liver cirrhosis and hepatocellular carcinoma related to hepatitis B virus infection.","authors":"Yanping Wang, Huan Wang, Shuai Wei, Zhiliang Gao, Haili Gao, Xinwei Wang, Haijun Liang, Daokun Yang","doi":"10.1097/MEG.0000000000003021","DOIUrl":"10.1097/MEG.0000000000003021","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic hepatitis B virus (HBV) infection can increase the risk of developing liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Timely detection of precancerous lesions for patients with chronic HBV infection is critical in preventing worse consequences. The purpose of this study is to reveal the key serum metabolic biomarkers that can be applied to the early recognition of HCC in patients with HBV-associated cirrhosis.</p><p><strong>Methods: </strong>Blood samples from patients with LC, HCC, and healthy subjects were collected, and endogenous metabolites in serum were detected by ultra high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF/MS). Differential metabolites (DM) were screened, and metabolic pathways and Kyoto Encyclopedia of Genes and Genomes signals involved in DM were analyzed.</p><p><strong>Results: </strong>Metabolomics results revealed that patients with LC and HCC had significantly different metabolic characteristics. Patients with LC and HCC shared 22 biomarkers, LC had six different biomarkers, and HCC had 10 different biomarkers. The expressions of these metabolites all showed significant differences between groups. Pathway enrichment analysis revealed that the differential biomarkers of LC were primarily involved in the regulation of phospholipid biosynthesis, while the differential biomarkers of HCC were mainly involved in the regulation of endogenous androgen signaling, mitochondrial fatty acid metabolism, and purine metabolism signaling. The common biomarkers are enriched in bile acid metabolism, amino acid metabolism, and arachidonic acid metabolism.</p><p><strong>Conclusion: </strong>We clarified the blood metabolism characteristics of LC and HCC. These findings provided potential endogenous metabolic indicators for early recognition of HBV-chronically infected cirrhotic patients who may progress to HCC.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"37 9","pages":"1040-1048"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lens culinaris-agglutinin-reactive fraction of alpha-fetoprotein is a prognostic biomarker in atezolizumab plus bevacizumab for hepatocellular carcinoma.","authors":"Jumpei Okamura, Hideyuki Tamai","doi":"10.1097/MEG.0000000000002979","DOIUrl":"10.1097/MEG.0000000000002979","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the prognostic ability of the lens culinaris-agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) in atezolizumab plus bevacizumab combination therapy (ATZ/BV) for unresectable hepatocellular carcinoma (u-HCC).</p><p><strong>Methods: </strong>The analysis included 78 u-HCC patients who were evaluated for early tumor response after 6 weeks of ATZ/BV. Positivity for tumor markers (TMs), including AFP, AFP-L3, and des-gamma-carboxy prothrombin (DCP), was defined as elevated values of AFP (≥100 ng/ml), AFP-L3 (≥10%), and DCP (≥100 mAU/ml), and the TM score was defined as the sum of the number of positive TMs. Early tumor response was defined as a response 6 weeks after the start of therapy.</p><p><strong>Results: </strong>AFP-L3 was identified as an independent prognostic factor in multivariate analysis. The median overall survival (OS) times in the AFP-L3-negative and -positive groups were 23.3 and 9.5 months, respectively ( P  = 0.002). The OS times in the TM score 0-2 and score 3 were 13.8 and 8.2 months, respectively ( P  = 0.013). AFP-L3 was also an independent predictor of early disease control (DC). When the cutoff for AFP-L3 was set at 80%, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting early DC were 94.4, 41.7, 78.5, 76.9, and 78.2%, respectively.</p><p><strong>Conclusion: </strong>AFP-L3 is a useful biomarker for predicting the response and prognosis of patients with ATZ/BV for u-HCC. AFP-L3 should be measured together with AFP and DCP levels.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1055-1062"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}